U.S. patent application number 11/459113 was filed with the patent office on 2007-02-22 for system and method of remotely directing radiation therapy treatment.
Invention is credited to Robert L. Cravens, John H. Hughes, Jeffrey M. Kapatoes, Weiguo Lu, Thomas R. Mackie, David Murray, Gustavo H. Olivera, Paul J. Reckwerdt, Kenneth J. Ruchala, Eric Schloesser, Eric Schnarr.
Application Number | 20070041498 11/459113 |
Document ID | / |
Family ID | 37683823 |
Filed Date | 2007-02-22 |
United States Patent
Application |
20070041498 |
Kind Code |
A1 |
Olivera; Gustavo H. ; et
al. |
February 22, 2007 |
SYSTEM AND METHOD OF REMOTELY DIRECTING RADIATION THERAPY
TREATMENT
Abstract
Systems and methods for utilizing remote access to a radiation
therapy treatment system. Remote access to the radiation therapy
treatment system can assist in providing quality assurance
processes, service and maintenance procedures, patient monitoring,
and statistical analysis.
Inventors: |
Olivera; Gustavo H.;
(Madison, WI) ; Mackie; Thomas R.; (Verona,
WI) ; Ruchala; Kenneth J.; (Madison, WI) ;
Hughes; John H.; (Madison, WI) ; Reckwerdt; Paul
J.; (Madison, WI) ; Cravens; Robert L.;
(Verona, WI) ; Kapatoes; Jeffrey M.; (Madison,
WI) ; Schnarr; Eric; (McFarland, WI) ;
Schloesser; Eric; (Mount Horeb, WI) ; Lu; Weiguo;
(Madison, WI) ; Murray; David; (Tauranga,
NZ) |
Correspondence
Address: |
MICHAEL BEST & FRIEDRICH, LLP
100 E WISCONSIN AVENUE
MILWAUKEE
WI
53202
US
|
Family ID: |
37683823 |
Appl. No.: |
11/459113 |
Filed: |
July 21, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
60701544 |
Jul 22, 2005 |
|
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Current U.S.
Class: |
378/65 |
Current CPC
Class: |
A61N 5/103 20130101;
A61N 5/1048 20130101; A61N 2005/1074 20130101 |
Class at
Publication: |
378/065 |
International
Class: |
A61N 5/10 20060101
A61N005/10 |
Claims
1. A method of remotely directing radiation therapy treatment of a
patient, the radiation therapy treatment being delivered by a
radiation therapy system, the method comprising: remotely accessing
patient information using a remote computer distinct from the
radiation therapy system; processing at least a portion of the
patient information; providing at least a portion of the processed
information to an on-site person at the radiation therapy system;
wherein at least a portion of the treatment has been delivered to
the patient; and wherein the patient information is derived from
the delivered portion.
2. A method as set forth in claim 1 and further comprising
notifying a person at a location distinct from the radiation
therapy system when a decision point has been reach during the
treatment.
3. A method as set forth in claim 2 wherein the method further
comprises determining the occurrence of the decision point at a
fixed point in the treatment.
4. A method as set forth in claim 2 wherein the decision point
occurs based on predefined actions.
5. A method as set forth in claim 2 wherein the notifying a person
is via the remote computer.
6. A method as set forth in claim 5 wherein the remote computer
comprises a hand-held device.
7. A method as set forth in claim 1 wherein the patient information
is accessed at a second remote computer distinct from the radiation
therapy system.
8. A method as set forth in claim 1 wherein the patient information
is accessed at the radiation therapy system.
9. A method as set forth in claim 1 and further comprising
approving or altering a course of treatment based at least in part
on the processed information.
10. A method as set forth in claim 9 wherein the approving or
altering the course of treatment includes approving or altering a
radiation therapy treatment plan.
11. A method as set forth in claim 10 and further comprising
performing the radiation therapy treatment plan in response to the
approving or altering the radiation therapy treatment plan.
12. A method as set forth in claim 1 and further comprising
generating a radiation therapy treatment plan for the patient based
at least in part on the processed information.
13. A method as set forth in claim 12 wherein the providing act
includes providing the radiation therapy treatment plan to the
on-site person.
14. A method as set forth in claim 12 wherein the generating a
radiation therapy treatment plan occurs at the radiation therapy
system.
15. A method as set forth in claim 1 wherein the providing act
includes delivering at least a portion of the processed information
to the on-site person.
16. A method as set forth in claim 1 wherein the providing act
includes making available at least a portion of the processed
information to the on-site person.
17. A method as set forth in claim 1 wherein at least a portion of
the provided information includes original, remotely-accessed
patient information.
18. A method as set forth in claim 1 wherein the processing act
includes generating a radiation therapy treatment plan, and wherein
the providing act includes providing the radiation therapy
treatment plan to the on-site person.
19. A method as set forth in claim 18 and further comprising
providing the radiation therapy treatment plan to a person at a
location distinct from the radiation therapy system to have the
person approve the radiation therapy treatment plan.
20. A method as set forth in claim 1 wherein the processing act
includes making a decision by a person at a location distinct from
the radiation therapy system regarding approval, modification, or
creation of a treatment plan, and wherein the providing act
includes providing the decision.
21. A method as set forth in claim 1 wherein the processing act
includes making a decision by a person at a location distinct from
the radiation therapy system regarding approval, modification, or
creation of a patient setup, and wherein the providing act includes
providing the decision.
22. A method as set forth in claim 1 wherein the processing act
includes making a decision by a person at a location distinct from
the radiation therapy system regarding approval, modification, or
creation of a patient registration, and wherein the providing act
includes providing the decision.
23. A method as set forth in claim 1 wherein the processing act
includes making a decision by a person at a location distinct from
the radiation therapy system regarding approval, modification, or
creation of patient contours, and wherein the providing act
includes providing the decision.
24. A method as set forth in claim 1 wherein the processing act
includes making a decision by a person at a location distinct from
the radiation therapy system regarding approval, modification, or
creation of a patient quality assurance plan, and wherein the
providing act includes providing the decision.
25. A method as set forth in claim 1 wherein the processing act
includes making a decision by a person at a location distinct from
the radiation therapy system regarding approval, modification, or
creation of an adaptive therapy plan, and wherein the providing act
includes providing the decision.
26. A method of remotely directing radiation therapy treatment of a
patient, the radiation therapy treatment being delivered by a
radiation therapy system, the method comprising: remotely accessing
patient information using a remote computer distinct from the
radiation therapy system; processing at least a portion of the
patient information; generating radiation therapy information based
at least in part on the processed information; and providing the
radiation therapy information to an on-site person at the radiation
therapy system; wherein at least a portion of the treatment has
been delivered to the patient; and wherein the patient information
is derived from the delivered portion.
27. A method as set forth in claim 26 and further comprising
notifying a person at a location distinct from the radiation
therapy system when a decision point has been reach during
treatment.
28. A method as set forth in claim 27 wherein the method further
comprises determining the occurrence of the decision point at a
fixed point in the treatment.
29. A method as set forth in claim 27 wherein the decision point
occurs based on predefined actions.
30. A method as set forth in claim 26 wherein the notifying a
person is via the remote computer.
31. A method as set forth in claim 30 wherein the remote computer
comprises a hand-held device.
32. A method as set forth in claim 26 wherein the patient
information is accessed at a second remote computer distinct from
the radiation therapy system.
33. A method as set forth in claim 26 wherein the patient
information is accessed at the radiation therapy system.
34. A method as set forth in claim 26 and further comprising, prior
to the providing the radiation therapy information, approving or
altering a radiation therapy treatment plan.
35. A method as set forth in claim 34 and further comprising
performing the radiation therapy treatment plan in response to the
approving or altering the radiation therapy treatment plan.
36. A method as set forth in claim 26 wherein the providing act
includes delivering at least a portion of the radiation therapy
information to the on-site person.
37. A method as set forth in claim 26 wherein the providing act
includes making available at least a portion of the radiation
therapy information to the on-site person.
38. A method as set forth in claim 26 and further comprising
providing the radiation therapy information to a person at a
location distinct from the radiation therapy system to have the
person approve a radiation therapy treatment plan.
39. A method as set forth in claim 26 wherein the radiation therapy
information includes a radiation therapy treatment plan and further
comprising making a decision by a person at a location distinct
from the radiation therapy system regarding approval or
modification of the radiation therapy treatment plan, and providing
the decision to the on-site person.
40. A method as set forth in claim 26 wherein the processing act
includes making a decision by a person at a location distinct from
the radiation therapy system regarding approval, modification, or
creation of a patient setup.
41. A method as set forth in claim 26 wherein the processing act
includes making a decision by a person at a location distinct from
the radiation therapy system regarding approval, modification, or
creation of a patient registration.
42. A method as set forth in claim 26 wherein the processing act
includes making a decision by a person at a location distinct from
the radiation therapy system regarding approval, modification, or
creation of patient contours.
43. A method as set forth in claim 26 wherein the processing act
includes making a decision by a person at a location distinct from
the radiation therapy system regarding approval, modification, or
creation of an adaptive therapy plan.
44. A system for remotely directing radiation therapy treatment of
a patient, the radiation therapy treatment being delivered by a
radiation therapy system, the system comprising: a computer
processor distinct from the radiation therapy system; and a
software program stored in a computer readable medium distinct from
the radiation therapy system and accessible by the computer
processor, the software program being executable by the computer
processor to access patient information, process at least a portion
of the patient information, and provide at least a portion of the
processed information to an on-site person at the radiation therapy
system.
45. A system as set forth in claim 44 wherein the software program
is further executable by the computer processor to notify a person
at a location distinct from the radiation therapy system when a
decision point has been reached.
46. A system as set forth in claim 44 wherein the accessed patient
information is from a second computer processor distinct from the
radiation therapy system.
47. A system as set forth in claim 44 wherein the accessed patient
information is from the radiation therapy system.
48. A system as set forth in claim 44 wherein the software program
is further executable by the computer processor to generate a
radiation therapy treatment plan for the patient based at least in
part on the processed information.
49. A system as set forth in claim 48 wherein the providing act
includes providing the radiation therapy treatment plan to the
on-site person.
50. A system as set forth in claim 48 wherein the generating a
radiation therapy treatment plan occurs at the radiation therapy
system.
51. A system as set forth in claim 44 wherein the software program
is further executable by the computer processor to provide the
radiation therapy treatment plan to a person at a location distinct
from the radiation therapy system to have the person approve the
radiation therapy treatment plan.
52. A system as set forth in claim 44 wherein the providing at
least a portion of the processed information includes delivering at
least a portion of the processed information to the on-site
person.
53. A system as set forth in claim 44 wherein the providing at
least a portion of the processed information includes making
available at least a portion of the processed information to the
on-site person.
54. A system as set forth in claim 44 wherein the processing at
least a portion of the patient information includes requesting a
decision by a person at a location distinct from the radiation
therapy system to approve, modify, or create a treatment plan.
55. A system as set forth in claim 44 wherein the processing at
least a portion of the patient information includes requesting a
decision by a person at a location distinct from the radiation
therapy system to approve, modify, or create a patient setup.
56. A system as set forth in claim 44 wherein the processing at
least a portion of the patient information includes requesting a
decision by a person at a location distinct from the radiation
therapy system to approve, modify, or create a patient
registration.
57. A system as set forth in claim 44 wherein the processing at
least a portion of the patient information includes requesting a
decision by a person at a location distinct from the radiation
therapy system to approve, modify, or create patient contours.
58. A system as set forth in claim 44 wherein the processing at
least a portion of the patient information includes requesting a
decision by a person at a location distinct from the radiation
therapy system to approve, modify, or create a patient quality
assurance plan.
59. A system as set forth in claim 44 wherein the processing at
least a portion of the patient information includes requesting a
decision by a person at a location distinct from the radiation
therapy system to approve, modify, or create an adaptive therapy
plan.
Description
RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Provisional
Patent Application No. 60/701,544; filed on Jul. 22, 2005; entitled
SYSTEMS AND METHODS OF REMOTELY ACCESSING A RADIATION THERAPY
TREATMENT SYSTEM; the entire content of which is incorporated
herein by reference.
BACKGROUND
[0002] Over the past decades, improvements in computers and
networking, radiation therapy treatment planning software, and
medical imaging modalities have been incorporated into radiation
therapy practice.
SUMMARY
[0003] There are many clinical processes, both for patient
treatment and system quality assurance/maintenance that would
benefit from remote technologies. The benefits of providing remote
access to a radiation therapy treatment system are numerous. Remote
access to a radiation therapy treatment system can address issues
such as quality assurance, service and maintenance procedures,
patient monitoring, and statistical analysis. Medical personnel and
technicians can remotely access a radiation therapy treatment
system allowing for a flexible system with various operational
options. Medical personnel can analyze patient information and
technicians can handle set-up and service issues from remote
terminals.
[0004] In one embodiment, the invention provides a method of
remotely reviewing a radiation therapy treatment plan for a
patient. The method includes the acts of accessing a radiation
therapy treatment system with a computer remote from the radiation
therapy treatment system, monitoring a parameter of the radiation
therapy treatment system, analyzing the parameter, comparing the
parameter to a predefined range, and notifying personnel local to
the radiation therapy treatment system if the parameter is not
within the predefined range.
[0005] In another embodiment, the invention provides a method of
treating a patient with radiation therapy. The method includes the
acts of acquiring an image of a patient at a first location,
generating a radiation therapy treatment plan for the patient,
notifying medical personnel at a second location that a treatment
plan has been generated for the patient, remotely accessing a
computer that generated the treatment plan to review the treatment
plan, and performing the treatment plan.
[0006] In another embodiment, the invention provides a method of
remotely directing radiation therapy treatment of a patient. The
radiation therapy treatment is delivered by a radiation therapy
system. The method comprises the acts of remotely accessing patient
information using a remote computer distinct from the radiation
therapy system, processing at least a portion of the patient
information, and providing at least a portion of the processed
information to an on-site person at the radiation therapy
system.
[0007] In another embodiment, the invention provides a method of
remotely directing radiation therapy treatment of a patient. The
radiation therapy treatment is delivered by a radiation therapy
system. The method comprises the acts of remotely accessing patient
information using a remote computer distinct from the radiation
therapy system, processing at least a portion of the patient
information, generating radiation therapy information (e.g.,
radiation therapy treatment plans, contours, patient prescriptions,
and the like) based at least in part on the processed information,
and providing the radiation therapy information to an on-site
person at the radiation therapy system.
[0008] In another embodiment, the invention provides a system for
remotely directing radiation therapy treatment of a patient. The
radiation therapy treatment is delivered by a radiation therapy
system. The system comprises a computer processor distinct from the
radiation therapy system, and a software program stored in a
computer readable medium distinct from the radiation therapy system
and accessible by the computer processor. The software program is
executable by the computer processor to access patient information,
process at least a portion of the patient information, and provide
at least a portion of the processed information to an on-site
person at the radiation therapy system.
[0009] Other aspects of the invention will become apparent by
consideration of the detailed description and accompanying
drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] FIG. 1 is a partial perspective view, partial schematic
illustration of a radiation therapy system.
[0011] FIG. 2 is a schematic illustration of the radiation therapy
system of FIG. 1.
[0012] FIG. 3 is a schematic illustration of a network for remote
access to the radiation therapy system of FIG. 1
[0013] FIG. 4 is block diagram of a software program that can be
used in the radiation therapy system of FIG. 1 or a remote computer
of FIG. 3.
[0014] FIG. 5 is a block diagram of a software program that can be
used in the remote computer of FIG. 3.
[0015] FIG. 6 is a flow chart illustrating a method of operation of
the software programs of FIGS. 4 and 5 according to one embodiment
of the invention.
[0016] FIG. 7 is a flow chart illustrating a method of operation of
the software programs of FIGS. 4 and 5 according to one embodiment
of the invention.
[0017] FIG. 8 is a flow chart illustrating a method of operation of
the software programs of FIGS. 4 and 5 according to one embodiment
of the invention.
[0018] FIG. 9 is a flow chart illustrating a method of operation of
the software programs of FIGS. 4 and 5 according to one embodiment
of the invention.
[0019] FIG. 10 is a flow chart illustrating a method of operation
of the software programs of FIGS. 4 and 5 according to one
embodiment of the invention.
DETAILED DESCRIPTION
[0020] Before any embodiments of the invention are explained in
detail, it is to be understood that the invention is not limited in
its application to the details of construction and the arrangement
of components set forth in the following description or illustrated
in the following drawings. The invention is capable of other
embodiments and of being practiced or of being carried out in
various ways. Also, it is to be understood that the phraseology and
terminology used herein is for the purpose of description and
should not be regarded as limiting. The use of "including,"
"comprising," or "having" and variations thereof herein is meant to
encompass the items listed thereafter and equivalents thereof as
well as additional items. Unless specified or limited otherwise,
the terms "mounted," "connected," "supported," and "coupled" and
variations thereof are used broadly and encompass both direct and
indirect mountings, connections, supports, and couplings. Further,
"connected" and "coupled" are not restricted to physical or
mechanical connections or couplings.
[0021] Although directional references, such as upper, lower,
downward, upward, rearward, bottom, front, rear, etc., may be made
herein in describing the drawings, these references are made
relative to the drawings (as normally viewed) for convenience.
These directions are not intended to be taken literally or limit
the invention in any form. In addition, terms such as "first",
"second", and "third" are used herein for purposes of description
and are not intended to indicate or imply relative importance or
significance.
[0022] In addition, it should be understood that embodiments of the
invention include hardware, software, and electronic components or
modules that, for purposes of discussion, may be illustrated and
described as if the majority of the components were implemented
solely in hardware. However, one of ordinary skill in the art, and
based on a reading of this detailed description, would recognize
that, in at least one embodiment, the electronic based aspects of
the invention may be implemented in software. As such, it should be
noted that a plurality of hardware and software based devices, as
well as a plurality of different structural components may be
utilized to implement the invention. Furthermore, and as described
in subsequent paragraphs, the specific mechanical configurations
illustrated in the drawings are intended to exemplify embodiments
of the invention and that other alternative mechanical
configurations are possible.
[0023] FIGS. 1 and 2 illustrate one construction of a radiation
therapy system 10 that can provide radiation therapy to a patient
14. The radiation therapy treatment can include photon-based
radiation therapy, brachytherapy, electron beam therapy, proton,
neutron, or particle therapy, or other types of treatment therapy.
The radiation therapy system 10 includes a radiation therapy device
18 having a gantry 22. Though the gantry 22 shown in the drawings
is a ring gantry, i.e., it extends through a full 360.degree. arc
to create a complete ring or circle, other types of mounting
arrangements may also be employed. For example, a C-type, partial
ring gantry, or robotic arm could be used.
[0024] The gantry 22 can support a radiation module 26, having a
radiation source and a linear accelerator (collectively shown as
30) operable to generate a beam 34 of photon radiation. The
radiation module 26 can also include a modulation device 38
operable to modify or modulate the radiation beam 34. The
modulation device 38 provides the modulation of the radiation beam
34 and directs the radiation beam 34 toward the patient 14.
Specifically, the radiation beam 30 is directed toward a portion of
the patient. Broadly speaking, the portion may include the entire
body, but is generally smaller than the entire body and can be
defined by a two-dimensional area and/or a three-dimensional
volume. A portion desired to receive the radiation, which may be
referred to as a target or target region (shown as 42), is an
example of a region of interest. Another type of region of interest
is a region at risk. If a portion includes a region at risk, the
radiation beam is preferably diverted from the region at risk. The
patient 14 may have more than one target region 42 that needs to
receive radiation therapy. Such modulation is sometimes referred to
as intensity modulated radiation therapy ("IMRT").
[0025] Other frameworks capable of positioning the radiation module
at various rotational and/or axial positions relative to the
patient 14 may also be employed. In addition, the radiation module
26 may travel in path that does not follow the shape of the gantry
22. For example, the radiation may travel in a non-circular path
even though the illustrated gantry 2 is generally
circular-shaped.
[0026] The radiation therapy device 18 can also include a detector
46, e.g., a kilovoltage or a megavoltage detector, operable to
receive a radiation beam from the treatment radiation source or
from a separate radiation source. The linear accelerator and the
detector 46 can also operate as a computed tomography (CT) system
to generate CT images of the patient 14.
[0027] The CT images can be acquired with a radiation beam 34 that
has a fan-shaped geometry, a multi-slice geometry or a cone-beam
geometry. In addition, the CT images can be acquired with the
linear accelerator 30 delivering megavoltage energies or
kilovoltage energies.
[0028] The radiation therapy treatment system 10 can also include a
patient support, such as a couch 54 (illustrated in FIG. 1), which
supports the patient 14. The couch 54 moves along at least one axis
in the x, y, or z directions. In other constructions, the patient
support can be a device that is adapted to support any portion of
the patient's body, and is not limited to having to support the
entire patient's body. The system 10 also can include a drive
system 58 operable to manipulate the position of the couch 54. The
drive system 58 can be controlled by the computer 50.
[0029] As used herein, the term "computer" is broadly construed as
an electronic device that receives, processes, and/or transmits
information according to instructions. As used herein, the term
"information" is broadly construed to include signals or data. The
computer 50, illustrated in FIG. 2, includes an operating system
for running various software programs and/or communication
applications. In particular, the computer 50 can include a software
program 62 operable to communicate with the radiation therapy
device 18. The computer 50 can include any suitable input/output
device adapted to be accessed by medical personnel. The computer 50
can include typical hardware such as a processor, I/O interfaces,
and storage devices or memory. The computer 50 can also include
input devices such as a keyboard and a mouse. The computer 50 can
further include standard output devices, such as a monitor. In
addition, the computer 50 can include peripherals, such as a
printer and a scanner.
[0030] The radiation therapy device 18 communicates directly with
the computer 50 and/or via a network 66 as illustrated in FIG. 2.
The radiation therapy device 18 also can communicate with other
radiation therapy devices 18 via the network 66. Likewise, the
computer 50 of each radiation therapy device 18 can communicate
with a computer 50 of another radiation therapy device 18. The
computers 50 and radiation therapy devices 18 can also communicate
with a database 70 and a server 74. A plurality of databases 70 and
servers 74 can also communicate with the network 66. It is noted
that the software program 62 could also reside on the server
74.
[0031] The network 66 can be built according to any networking
technology or topology or combinations of technologies and
topologies and can include multiple sub-networks. Connections
between the computers 50 and devices 18 shown in FIG. 2 can be made
through local area networks ("LANs"), wireless area networks
("WLANs"), wide area networks ("WANs"), public switched telephone
networks ("PSTNs"), Intranets, the Internet, or any other suitable
networks. In a hospital or medical care facility (collectively
referred to as a health-care facility), communication between the
computers 50 and devices 18 shown in FIG. 2 can be made through the
Health Level Seven ("HL7") protocol with any version and/or other
required protocol. HL7 is a standard protocol that specifies the
implementation of interfaces between two computer applications
(sender and receiver) from different vendors for electronic data
exchange in health care environments. HL7 can allow health care
institutions to exchange key sets of data from different
application systems. Specifically, HL7 can define the data to be
exchanged, the timing of the interchange, and the communication of
errors to the application. The formats are generally generic in
nature and can be configured to meet the needs of the applications
involved.
[0032] Communication between the computers 50 and radiation therapy
devices 18 shown in FIG. 2 can also occur through the Digital
Imaging and Communications in Medicine (DICOM) protocol with any
version and/or other required protocol. DICOM is an international
communications standard developed by the National Electrical
Manufacturers Association (NEMA) that defines the format used to
transfer medical image-related data between different pieces of
medical equipment. DICOM RT refers to the standards that are
specific to radiation therapy data.
[0033] The two-way arrows in the drawings generally represent
two-way communication and information transfer between the network
66 and any one of the computers 50, the radiation therapy devices
18, and other components shown in the drawings. However, for some
medical equipment, only one-way communication and information
transfer may be necessary.
[0034] FIG. 3 schematically illustrates a radiation therapy system
10 that can be accessed by a remote computer 78 via a network 82.
The remote computer 78 can be a handheld device, such as a PDA or
tablet PC. The remote computer 78 can access the radiation therapy
system 10, which is distinct from the remote computer 78. Before
proceeding further, it should be understood that the remote
computer 78 may or may not be located in the same facility as the
radiation therapy system 10 (or the image acquisition device 90),
and the computer 50 may or may not be located in the same room as
the radiation therapy device 18. It is conceivable, for example,
that the computer 50 not be proximate to the radiation therapy
device 18, the remote computer 78 to be located in the same
facility as the radiation therapy system 10, but that the remote
computer 78 be distinct from the radiation therapy system 10
(including the computer 50).
[0035] The remote computer 78 includes an operating system for
running various software programs and/or communication
applications. In particular, the remote computer 78 can include a
software program 86 operable to communicate with the radiation
therapy system 10, the network 82, and other software for remote
applications and communications. The remote computer 78 can include
any suitable input/output device adapted to be accessed by medical
personnel. The remote computer 78 can include hardware such as a
processor, I/O interfaces, and storage devices or memory. The
remote computer 78 can also include input devices such as a
keyboard and a mouse, touch screen monitor. The remote computer 78
can further include standard output devices, such as a monitor. In
addition, the remote computer 78 can include peripherals, such as a
printer and/or a scanner.
[0036] The remote computer 78 enables medical personnel and
technicians access to the radiation therapy system 10 while being
on the move or in process of changing locations. As one example,
medical personnel can view patient treatment history as well as
edit and approve patient treatment plans without being at the site
of the radiation therapy system 10. Medical personnel also can
generate, view, and edit contours, which are generated to identify
the regions of interest in the CT images of the patient 14 and the
target 42. The contours also define the boundaries and the amount
of radiation that a specific area or space of the target 42 will
receive. Medical personnel also can approve or modify the treatment
plan for a patient while at a remote location. The remote computer
78 provides a tool for medical personnel to manage patient and
treatment information while providing mobility and convenience to
the medical personnel.
[0037] The network 82 can be built according to any networking
technology or topology or combinations of technologies and
topologies and can include multiple sub-networks. Connections
between the remote computers 78 and radiation therapy systems 10
shown in FIG. 3 can be made through local area networks ("LANs"),
wireless area networks ("WLANs"), wide area networks ("WANs"),
public switched telephone networks ("PSTNs"), intranets, the
Internet, or any other suitable networks. In a hospital or medical
care facility, communication between the remote computers 78 and
radiation therapy systems 10 shown in FIG. 3 can be made through
the Health Level Seven ("HL7") protocol with any version and/or
other required protocol. HL7 is a standard protocol that specifies
the implementation of interfaces between two computer applications
(sender and receiver) from different vendors for electronic data
exchange in health care environments. HL7 can allow health care
institutions to exchange key sets of data from different
application systems. Specifically, HL7 can define the data to be
exchanged, the timing of the interchange, and the communication of
errors to the application. The formats are generally generic in
nature and can be configured to meet the needs of the applications
involved.
[0038] Communication between the remote computers 78 and the
radiation therapy systems 10 shown in FIG. 3 can also occur through
the Digital Imaging and Communications in Medicine (DICOM) protocol
with any version and/or other required protocol. DICOM is an
international communications standard developed by NEMA that
defines the format used to transfer medical image-related data
between different pieces of medical equipment. DICOM RT refers to
the standards that are specific to radiation therapy data.
[0039] Communication can also occur through remote access to the
computer interface and/or through a web-type interface (e.g., java,
html, etc.) Communication can also occur through images of the
relevant data such as a screen image of a plan viewed over the web
without having to actually commandeer the planning computer.
[0040] The radiation therapy system 10 can communicate with and
import and export data from one or more image acquisition devices
90, as illustrated in FIG. 3. In addition, the remote computers 78
can communicate with the image acquisition device 90.
[0041] The two-way arrows in FIG. 3 generally represent two-way
communication and information transfer between the network 82 and
any one of the remote computers 78, the radiation therapy systems
10, and other components shown in FIG. 3. However, for some medical
equipment, only one-way communication and information transfer may
be necessary. It should also be understood that the communication
of information can be via a transmission or delivery of information
and/or can be via making the information available (e.g., at a web
site) for acquisition.
[0042] One exemplary software program 62 is schematically
illustrated in FIG. 4. The software program 62 can be accessed
remotely by the remote computer 78 and software program 86. The
remote computer 78 communicates with the network 82 and the
radiation therapy system 10 (computer 50 and/or radiation therapy
device 18).
[0043] It is noted that various components and modules are
discussed below with respect to the software program 62, however
some or all of the components and modules could also be implemented
in the software program 86. It is also noted that the processing
activities could occur at either the computer 50, remote computer
78, and/or server 74. One particular benefit of remote processing
of data is the opportunity for improved speed.
[0044] The software program 62 includes a system setup module 94
operable to configure the radiation therapy device 18. The system
setup module 94 is also operable to determine whether the device 18
is properly commissioned, that the output and geometry of the
modulation device 38 and imaging system are correctly modeled and
within predetermined tolerances, and that the device 18 is ready
for patient use. The system setup module 94 can also conduct
predefined commissioning steps of the device 18, such as
measurements of output, alignment, profiles, stability, geometry,
couch performance, modulation device motion, gantry
positioning/motion, and other device parameters.
[0045] The software program 62 also includes a quality assurance
module 98 operable to conduct various tests and analyze the status
and performance of the device 18. The quality assurance module 98
includes a test module 102 operable to conduct various tests on the
device 18, such as radiation measurements, to verify proper
operation. The personnel local to the radiation therapy device 18
(also referred to as the on-site personnel) can inform the remote
site when to conduct tests and the types of tests to be conducted.
Some of the tests may require that local personnel or a physicist
perform a set of predefined preparatory steps, such as setting up
jigs and phantoms, placing films, ion chambers, or other radiation
measurement devices. These preparatory steps can be done by the
local personnel before leaving for the evening or at other times
when the device 18 is not being used. Other tests may require some
local assistance, such as developing films or modifying setups.
[0046] The test module 102 is also operable to acquire and save
data that is generated by performance of the tests. The test module
102 can retrieve patient specific data, such as data related to the
delivery of a patient's treatment plan or future patient treatment
plans, stored in the device 18 and/or computer 50.
[0047] The quality assurance module 98 also includes an analysis
module 106 operable to analyze the data acquired from the tests
that were conducted by the test module 102 and the patient specific
data. The analysis module 106 evaluates the test results to
determine if the device 18 is within predefined tolerances and
otherwise in proper operational condition. The analysis module 106
can compare the test results of the device 18 to previous test
results from the same device 18 and/or to test results from other
radiation therapy devices 18. The analysis module 106 can evaluate
delivery parameters of a treatment plan to determine if the device
18 delivered the treatment plan as expected. The analysis module
106 can also compare delivery parameters of more than one treatment
plan of the same patient or different patients to determine if the
device 18 delivered the treatment plan as expected. In some
instances, the data results may help identify if the device 18
needs tuning and/or maintenance. The analysis module 106 can
evaluate future patient treatment plans to verify that the plan and
its associated device setup is suitable for delivery.
[0048] The analysis module 106 can specify whether local personnel
need to take remedial action and/or identify whether additional
tests or calibration should be performed on the device 18 if the
analysis module 106 identifies an anomaly with the device 18 based
on the test results. The analysis module 106 can also recommend
changes to future patient treatment plans to compensate for changes
that may be made to the device 18 as a result of retuning and/or
maintenance.
[0049] The system setup module 94 and the quality assurance module
98 can improve the physics and quality assurance processes by
offering consistency, automation, and efficiency. The features
provided by the system setup module 94 and the quality assurance
module 98 can be implemented in medical clinics (or elsewhere) that
wish to save time in conducting the quality assurance processes for
the device 18. The features offered by the modules 94 and 98 allow
a medical clinic to receive oversight and training when beginning
to use the device 18.
[0050] Medical personnel, at the remote computer 78, can instruct
the test module 102 to perform a specified test of the device 18.
The medical personnel, again from the remote computer 78, can
instruct the analysis module 106 to evaluate the test results.
Alternatively, the analysis module 106 can automatically analyze
the test results. The analysis module 106 can transmit a report of
the analysis results and/or recommendations to the remote computer
78 for review by the medical personnel.
[0051] The software program 62 also includes a training module 110
operable to monitor operation of the device 18 as medical personnel
learn to operate and interact with the device 18. The training
module 110 can provide step-by-step instructions for setup of the
device 18 for quality assurance tests and/or for patient use. For
example, the remote computer 78 can instruct the training module
110 to operate the device 18 and conduct various tests and/or
operate according to a treatment plan while the medical personnel
observes. Also, the training module 110 allows personnel at the
remote computer 78 to monitor medical personnel as they operate the
device 18. Personnel at the remote computer 78 can provide
suggestions and advice to the local personnel on how to operate the
device 18. Similarly, personnel at the remote computer 78 can
monitor or supervise the local personnel during patient treatments.
Training of medical personnel can be performed through the network
82 using the remote computer 78 to operate the training module 110
and radiation therapy device 18, and deliver instructions to
trainees in real-time.
[0052] The software program 62 also includes a service module 114
operable to monitor component performance and reliability and
environmental factors of the radiation therapy device 18. The
service module 114 includes a monitoring module 118 operable to
monitor environmental factors such as temperature, humidity, and
air pressure of the room in which the device 18 is located. The
monitoring module 118 is also operable to monitor parameters of the
device 18, such as water flow, internal temperature, internal
pressure, and the like. The monitoring module 118 can also monitor
performance of external components, such as ion chambers, water
tanks, diodes, film/film processors and the like. The monitoring
module 118 can monitor in real-time the environmental factors, the
device parameters, and the external components as the device 18 is
in operation.
[0053] The service module 114 also includes a tracking module 122
operable to record and track the parameter data of the monitoring
module 118. The tracking module 122 can compare the monitored
parameter data to historical parameter data to identify device
component problems. For example, the tracking module can compare
recent parameter data relating to the beam of radiation from the
radiation module 30 with historical parameter data relating to the
beam of radiation from the radiation module 30. The tracking module
122 can automatically generate a report when a device component
problem is identified and transmit the report to the remote
computer 78. The tracking module 122 can generate a notification
via phone, electronic mail, beeper, system messaging, or other
modes of communication based on the type of component problem
identified. In addition, the remote computer 78 can access the
tracking module 122 to review the status of the parameter data to
identify risk factors that indicate unsafe treatments to reduced
machine stability to component failure. The remote computer 78 can
instruct the service module 114 to correct the identified problem.
For example, the remote computer 78 can instruct the service module
114 to retune or realign the device 18, change the room
temperature, and schedule a component replacement.
[0054] The software program 62 also includes a treatment module 126
operable to perform functions related to patient treatment plans.
There are numerous stages of the radiation therapy treatment
process in which a clinical decision (or revision), approval, or
judgment is necessary (collectively referred to as a decision
point). Medical personnel interact with the treatment module 126
via the remote computer 78 to oversee multiple patients 14,
treatment plans, and/or devices 18.
[0055] The treatment module 126 is operable to receive instructions
from the remote computer 78, which allows medical personnel to
view, edit, and/or approve patient plan optimization; view, edit,
and/or approve patient contours; view, edit, and/or approve patient
registration, and registration histories for a patient 14; view,
edit, and/or approve adaptive therapy; view, edit, and/or approve
quality assurance functions; view device history; view user
history; view patient history; contact service/schedule
maintenance; view data for other devices 18 or clinics; and
transfer and/or triage patients to other devices 18 or clinics.
[0056] The treatment module 126 can include a contouring module 130
operable to generate contours on an image, such as a planning
image. The contouring process is time consuming and may be
outsourced to a remote center or to an automated system. The remote
computer 78 can receive notification from the treatment module 126
that a treatment plan is waiting for the contours to be identified.
The contouring task can be performed by trained and qualified
personnel at the remote center. The local medical personnel can
then approve, edit, or reject the remotely performed work, which in
many cases could be done more efficiently. Alternatively, medical
personnel can access the contouring module 130, via the remote
computer 78, to view, edit, and/or approve the contours of a
patient treatment plan.
[0057] The treatment module 126 also includes a dose module 134
operable to acquire patient radiation dose information after a
treatment plan is delivered. The dose module 134 is operable to
recalculate dose and/or perform deformation after each fraction
based upon recent patient images, treatment parameters, and
treatment feedback information, such as exit dose. The dose module
134 can process and analyze the dose data in accordance with
specified tolerances. The dose module 134 can automatically
transmit the data and analyzed results to the remote computer 78
for review. Medical personnel can review the dose data at the
remote computer 78 and transmit suggestions back to the dose module
134 to make adjustments or determine whether the treatment is
progressing according to the plan. The local personnel can review
the suggestions made by the remote personnel and approve, alter, or
reject the suggestions. The suggestions of the remote personnel
could automatically be implemented if the local personnel provide a
pre-approval for all suggestions, a sub-set of the suggestions, or
changes that would fall within a predefined range made by the
remote personnel.
[0058] The treatment module 126 also includes a monitoring module
138 operable to monitor all aspects of a treatment. The monitoring
module 138 can include the use of video cameras that monitor the
patient 14 and local medical personnel and windows into the device
18 and computer 50 that operate the device 18. The remote computer
78 can access the monitoring module 138 to monitor all aspects of
radiation treatment from a remote location. The monitoring module
138 can be used for training, additional safety, or more
efficiency. The remote computer 78 can access the monitoring module
138 such that remote medical personnel can view and/or adjust a
treatment (e.g., positional parameters for gating, ultra sound,
implantable markers, camera based tracking, detector data, and
spirometric data) either in real-time or post-treatment. The
monitoring module 138 can receive instructions from the remote
computer 78 to adjust/discontinue treatment if certain tolerances
are exceeded and/or predetermined protocols are not followed. The
monitoring module 138 can generate a report or a notification to
the remote computer 78 if certain tolerances are exceeded during
treatment, or to indicate that treatment or a phase of treatment
has been completed. Personnel at the remote computer 78 can notify
other specified parties by phone, paging, electronic mail, or other
modes of communication. Alternatively, the monitoring module 138
can notify other specified parties by phone, paging, electronic
mail, or other modes of communication.
[0059] The software program 86 is schematically illustrated in FIG.
5. The software program 86 includes a medical center data module
142 operable to acquire and analyze throughput from a plurality of
medical centers having radiation therapy systems 10. The medical
center data module 142 can communicate with the computer 50 and the
radiation therapy device 18 to retrieve data. The medical center
data module 142 can organize and evaluate clinical throughputs on
both a macroscopic (# of patients per day, etc.) level and a
microscopic (speeds and delays related to particular steps of the
treatment process) level. The medical center data module 142 can
compare speeds for particular clinicians, treatment types, medical
centers, etc. The medical center data module 142 can present
options for improving medical center efficiency. For example, the
medical center data module 142 could identify ways in which the
slower medical centers or persons could improve, while also
indicating how the radiation therapy system 10 could be improved
based upon use. It could also allow for comparison of treatment
plans, delivery times, opportunities for combined therapy, and
outcomes with other centers.
[0060] The medical center data module 142 could facilitate
scheduling for one or more medical centers by evaluating the speeds
and workloads of the centers, along with the current patient load,
machine downtime, patient distances to the different medical
centers, and other information. Less tangible factors, such as
patient willingness/unwillingness to travel, preference for
particular clinical personnel, or interest in faster/slower
fractionation schedules could also be incorporated. This queuing of
patients could be performed for a single medical center or for a
plurality of medical centers. Additional functionality can include
the conversion of plans for running on different radiation therapy
treatment devices 18, automated QA and physics necessary to run
plans at different medical centers, remote adaptive therapy to
monitor deliveries, accumulate dose, and adjust plans as needed,
notification of relevant personnel, and remote consultation with
primary clinicians.
[0061] The software program 86 also includes a plan conversion
module 146 operable to convert treatment plans generated by
different radiation therapy system manufacturers. The plan
conversion module 146 can also convert treatment plans generated by
radiation therapy systems 10 at different medical centers. The plan
conversion module 146 analyzes the treatment plan and system
settings generated by a radiation therapy system 10 of a first
manufacturer to generate a treatment plan and system settings for a
radiation therapy system 10 of a second manufacturer. Some factors
that may be considered during the conversion process are the type
of linear accelerator of the system, whether the couch or patient
support is movable, whether a ring-type gantry or a C-arm is
utilized, how a tumor is defined, and how dose is determined.
[0062] The software program 86 also includes a plan comparison
module 150 illustrated in FIG. 5. The plan comparison module 150 is
operable to compare treatment plans and assist the patient 14 in
comparing and shopping for radiation therapy treatment. The patient
14 may elect to have pre-treatment (or mid-treatment or even
post-treatment) data sent to a set of medical centers interested in
generating potential treatment plans. The plan comparison module
150 can receive and transmit the patient data to a plurality of
facilities for plan generation. The plan comparison module 150 can
receive the generated plans and compare the different plans, the
locations where treatment will be administered, treatment quality,
side-effects, personnel on site, and other parameters and make a
recommendation to the patient 14 based on certain requirements set
forth by the patient 14. The patient 14 can then enlist in
treatment at a preferred medical center. A planning center does not
need to perform the treatment itself, as another option is for a
remote planning center to export the plan to a local center where
the treatment can be delivered.
[0063] Alternatively, the patient 14 can have the treatment plan
evaluated by a consulting service to recommend a course of
treatment. The remote service offered through the plan comparison
module 150 can also be utilized during or after treatment for the
patient 14 to receive feedback as to whether treatment adjustments
are desired, and to evaluate if monitored changes in tumor, RAR, or
side-effects are consistent with any doses prescribed or
received.
[0064] FIG. 6 illustrates a flow chart of a method of configuring a
radiation therapy treatment device 18 from a remote location
according to one embodiment of the invention. Local personnel
perform (at 170) a set of predefined preparatory steps of the
device 18, such as setting up equipment. Local personnel request
(at 174) via the quality assurance module 98 that the device 18 be
tested or analyzed for proper operation. Remote personnel receive
(at 178) the request and access (at 182) the quality assurance
module 98 via the remote computer 78 and the network 82. Remote
personnel instruct (at 186) the test module 102 to conduct a
particular test on the device 18 (e.g., conduct a test on operation
of the gantry or the couch). After completion of the test, the
remote personnel instruct (at 190) the analysis module 106 to
evaluate the test results. The analysis module 106 generates (at
194) a report of the test results and transmits the report to the
remote computer 78. The remote personnel recommend (at 198)
remedial action if necessary. The analysis module 106 can
automatically recommend changes to the device 18.
[0065] FIG. 7 illustrates a flow chart of a method of monitoring
operation of a radiation therapy treatment device 18 from a remote
location according to one embodiment of the invention. Local
personnel request (at 202) via the service module 114 that the
device 18 be monitored during operation or that environmental
factors be evaluated or that external components be monitored.
Remote personnel receive (at 206) the request and access (at 210)
the service module 114 via the remote computer 78 and the network
82. Remote personnel instruct (at 214) the monitoring module 118 to
monitor a parameter of the device 18, such as water flow, internal
temperature, internal pressure, and the like or to monitor
environmental factors, such as temperature, humidity, and air
pressure or to monitor external components. The monitoring module
114 transmits (at 218) the acquired data to the tracking module
122. The tracking module 122 compares (at 222) the data to
historical data or predefined ranges to determine (at 226) if
device component problems or environmental problems or external
component problems exist. The tracking module 122 generates (at
230) a report of the results and transmits the report to the remote
computer 78. The remote computer 78 can access the tracking module
122 to retrieve the results. Based on the results, the remote
personnel instruct (at 234) the service module 114 to correct the
problem. The service module 114 can automatically correct the
problem rather than wait for the report.
[0066] FIG. 8 illustrates a flow chart of a method of remotely
reviewing a radiation therapy treatment plan for a patient
according to one embodiment of the invention. Local personnel
acquire (at 238) an image of the patient 14 and begin to generate
(at 242) a treatment plan for the patient. The local personnel
instruct (at 246) the treatment module 126 to notify remote
personnel that a treatment plan has been generated. The remote
personnel access (at 250) a computer 78 at a location different
from the local personnel, and review, approve, modify, and/or deny
(at 254) the treatment plan. Remote personnel can also view, edit,
and/or approve patient plan optimization; view, edit, and/or
approve patient contours; view, edit, and/or approve patient
registration, and registration histories for a patient 14; view,
edit, and/or approve adaptive therapy. If the remote personnel
approve the treatment plan, the local personnel commence (at 258)
treatment.
[0067] FIG. 9 illustrates a flow chart of a method of selecting a
location for radiation therapy treatment according to one
embodiment of the invention. Local personnel acquire (at 262) a
patient profile (e.g., information or data relating to the patient)
and transmit (at 266) the profile to a plurality of treatment
planning locations. Each location generates (at 270) a treatment
plan for the patient 14 based on the patient profile. Each location
transmits (at 274) the treatment plan to the plan comparison module
150. The plan comparison module 150 compares (at 278) the plurality
of plans to make (at 282) a recommendation to the patient 14 of
where to receive treatment.
[0068] FIG. 10 illustrates a flow chart of a method of scheduling
radiation therapy treatment for a patient 14 at a medical center
according to one embodiment of the invention. A medical center data
module 142 acquires (at 286) throughput data, such as speed and
workload, from a plurality of medical centers having a radiation
therapy system 10. The medical center data module 142 analyzes (at
290) the throughput data and determines (at 294) which medical
center can accommodate the patient 14 most efficiently. The medical
center data module 142 can also determine a particular treatment
unit to use. The medical center data module 142 can also take into
consideration patient willingness to travel, preference for
particular clinical personnel, and other patient related
factors.
[0069] Thus, the invention provides, among other things, new and
useful systems and methods of remotely accessing a radiation
therapy system. Various features and advantages of the invention
are set forth in the following claims.
* * * * *